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A Novel Association of Martorell Ulcer With Liddle Syndrome

Malphrus, Elizabeth BA, MPP; Couch, Kara MS, CRNP, CWS, CWCN-AP; Chao, Jerry W. MD

Advances in Skin & Wound Care: November 2019 - Volume 32 - Issue 11 - p 1–2
doi: 10.1097/01.ASW.0000582616.30031.19

ABSTRACT Pseudohyperaldosteronism, or Liddle syndrome, is a rare, autosomal dominant condition characterized by early-onset hypertension, often associated with hypokalemia and metabolic alkalosis. Martorell hypertensive ischemic leg ulcer is a rare, underdiagnosed ulcer characterized by subcutaneous arteriolosclerosis, classically appearing over the dorsolateral lower extremity or Achilles tendon in patients with hypertension and diabetes. It presents an important diagnostic challenge because it can appear grossly similar to other entities such as pyoderma gangrenosum or venous stasis ulcers, but requires surgical intervention. This article presents a case study of surgical management of a Martorell ulcer in a 69-year-old woman with Liddle syndrome. To the authors’ knowledge, this is the first case reported in the literature of this rare ulcer occurring secondary to this rare cause of hypertension.

At the George Washington University, in Washington, DC, Elizabeth Malphrus, BA, MPP, is a medical student, School of Medicine and Health Sciences; Kara Couch, MS, CRNP, CWS, CWCN-AP, is Director, Inpatient Wound Care, Wound Healing and Limb Preservation Center; and Jerry W. Chao, MD, is Assistant Professor of Surgery, School of Medicine and Health Sciences. The authors have disclosed no financial relationships related to this article. Submitted March 17, 2019; accepted in revised form May 14, 2019.

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